Provider Demographics
NPI:1366430217
Name:KRUGLEY, RICHARD (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:KRUGLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 LEFFERTS RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1347
Mailing Address - Country:US
Mailing Address - Phone:914-949-1199
Mailing Address - Fax:914-949-1245
Practice Address - Street 1:755 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-1111
Practice Address - Country:US
Practice Address - Phone:631-608-5620
Practice Address - Fax:631-396-0382
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132755-12084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00975948Medicaid
NYB11341Medicare UPIN
NY00975948Medicaid